10 Facts About MDMA August 2015 1. What is MDMA? and a desire to intensify these feelings by dancing, talking and touching. MDMA, often referred to as “ecstasy” or “molly”, is short for 3,4 methylenedioxymethamphetamine, a A typical dose of 80 - 125 mg lasts three to six hours. psychoactive drug derived from safrole oil. MDMA Some people experience nausea at the outset, but produces effects that resemble both stimulants and after about 45 minutes, report feelings of relaxation psychedelics, as well as its signature effect: a feeling and clarity. MDMA also causes dilation of the pupils of connectedness. It impacts brain function primarily and, often, sensitivity to light, as well as possible jaw- releasing the neurotransmitter serotonin, and also clenching, tooth-grinding, muscle tension, faintness, temporarily inhibits its reuptake. MDMA is usually and chills or sweating. taken orally, whether in pressed pill form, powder or crystal; or sometimes snorted. After the drug wears off, the theory from preclinical studies is that brain levels of serotonin (a chemical MDMA was originally synthesized in 1912 by the drug responsible for maintaining mood balance) are company Merck.1 However, its psychoactive effects depleted, which can lead in some cases to sadness, weren’t widely discovered until 1976 when Alexander anxiety, depression and sleep problems.4 If they occur, Shulgin developed a new synthesis method, tested the these symptoms arise in the several days that follow. drug on himself, and shared it with a few friendly Generally, they abate within a week, though frequency psychotherapists.2 Because of the drug’s effects of of use and higher doses can slow or stop this increasing empathy and reducing fear, it started to be process.5 used in psychotherapy practices in the 1970s and early 80s, as well as recreationally. In 1985 it became 3. What’s the difference between molly, ecstasy classified by the federal government as a Schedule I and MDMA? drug, meaning among the “most dangerous,” along with marijuana, LSD and heroin. Studies have shown, MDMA is the official scientific name for this drug. however, that MDMA is among the least harmful drugs “Molly” and “ecstasy” are both commonly-used slang (see question 6 for more details). Despite its Schedule terms. I status, MDMA is still commonly used at festivals, concerts and clubs; and research is ongoing into its However, since MDMA is currently illegal and therefore therapeutic benefits. unregulated, anything sold as “molly” or “ecstasy” could range from being pure MDMA, to being cut with 2. How will MDMA make me feel? other drugs, to containing no MDMA at all.6 The molly market is one of the most adulterated illicit drug People who use MDMA describe themselves as markets, meaning it often is cut with other feeling euphoric, open, accepting, unafraid, and substances.7 (See this full list of what ecstasy or molly connected to those around them.3 Typically used in may contain.) social settings like festivals, concerts and clubs, MDMA’s effects are stimulated by visuals, sounds, smells and touch, leading to heightened sensations Drug Policy Alliance | 131 West 33rd Street, 15th Floor, New York, NY 10001 Page 1 [email protected] | 212.613.8020 voice | 212.613.8021 fax 4. How can I tell if my molly or ecstasy contains harms, we strongly recommend that festivals offer free MDMA? water and areas for people to cool off. Since MDMA is currently illegal and therefore not Another concern for people who take MDMA is regulated, it is very difficult for an individual user to be hyponatremia – drinking too much water. This causes 100% certain what’s in any given dose. Drug checking, the sodium in the blood to dilute to critically low levels, also known as pill testing or adulterant screening, is a and seems to affect women more than men.11 This is harm reduction service that allows users to get more why, when available, juices and electrolyte- information about what is in their molly or other drugs. replenishing drinks are preferable to water. It can be done in several ways. The best way involves a precise, high- level testing method called gas 6. How risky is MDMA compared to other drugs? chromatography / mass spectrometry (GC/MS). Individuals can send a sample in to ecstasydata.org for As with all alcohol and other drug use, taking MDMA testing and wait 2 to 3 weeks for the lab results to be carries risks, albeit comparatively lower than most posted online. These results will list all substances other drugs.12 present in the sample with complete accuracy. For example, a 2010 study published in the prestigious There are also personal drug checking kits, which use Lancet journal was conducted to gauge the relative liquid chemical reagents to help potential users get a potential harms of drugs to both consumers and to better understanding of what’s in their substance. society, and MDMA was found to be among the least These kits come with a color chart that helps people risky.13 As you can see in the graph below, overall, determine what drug (if any) is mostly present in the alcohol was considered the most harmful drug, with substance they’ve tested. Users should also know that heroin and crack in second and third places. You’ll find these kits, while not considered illegal under federal MDMA hovering just above the bottom of the scale laws, can be considered drug paraphernalia depending with a significantly lower rating. Several other on how a state’s law is written. Nonetheless, we do researchers have independently reported similar recommend them as the most accessible and quick findings.14 It’s clear that a drug’s legal status has little screening tool. relation to its potential for harm. 5. Can you overdose on MDMA? Relative Harms of Drugs “Overdose” refers to taking a higher than appropriate Alcohol 72 Heroin 55 dose of a medicine or drug, which can happen with Crack 54 8 Methamphetamine 33 MDMA, but is extremely rare. It is much more likely Cocaine 27 that a problem would occur as a result of MDMA use Tobacco 26 Amphetamine 23 with contraindicated medications (such as MAOI anti- Cannabis 20 GHB 19 depressants), preexisting health conditions, Ketamine 15 overexertion, or dehydration.9 Given the highly Benzodiazepines 15 Methadone 14 adulterated molly market, it’s also more likely to see an Mephedrine 13 unidentified substance cause problems, rather than Butane 11 Anabolic steroids 10 MDMA itself. Ecstasy 9 Khat 9 Buprenorphine 7 Hyperthermia – a dangerously high increase in body LSD 7 Mushrooms 6 temperature, or heatstroke – is the most common health problem related to MDMA. Hyperthermic Source: Nutt, David J, et al., "Drug Harms in the UK: A Multicriteria reactions result from physical exertion (such as Decision Analysis." The Lancet 376, no. 9752 (2010): 1558-65. dancing) in an overheated environment without replenishing fluids, which is why it is strongly recommended that users take breaks and consume fluids such as water or electrolyte-replenishing drinks. In extreme cases, hyperthermia can cause liver, kidney or heart failure, or even death.10 To prevent these Drug Policy Alliance | 131 West 33rd Street, 15th Floor, New York, NY 10001 Page 2 [email protected] | 212.613.8020 voice | 212.613.8021 fax 7. What are the most common adulterants in 9. How many people use MDMA? what’s sold as “molly” or “ecstasy” (in other words, what chemicals is it commonly cut with)? Among the general population, MDMA use is not very common. According to the 2013 National Survey on Due to being one of the most adulterated drug Drug Use and Health, only 0.3 percent of people aged markets, the impurity of molly in different regions and 12 and older reported using “ecstasy” in the past at different times varies quite a bit – that is, there’s no month, 1 percent reported using it in the past year, and such thing as the “most common adulterants.” Besides 6.8 percent reported using at least once in their MDMA, “ecstasy” or “molly” may contain varying levels lifetime.22 The statistics for young people break down of: like this: Psychoactive substances designed to mimic Among young people ages 12-17, just 0.2 the effects of MDMA like MDA (methylene- percent reported using MDMA in the past dioxyamphetamine a.k.a. “sass”) or “bath month (compared to 7 percent using salts” (a general term for synthetic marijuana and 11.6 percent using alcohol), cathinones, a class of amphetamine-like and 0.9 percent in the past year (compared to stimulants); 13.4 percent using marijuana and 24.6 Stimulants like amphetamine, cocaine, percent using alcohol).23 caffeine or methamphetamine; or, more rarely Four percent of young adults ages 18-25 Anesthetics such as ketamine (“Special K”) or reported using MDMA in the past year dextromethorphan (DXM – an ingredient (compared to 31.6 percent using marijuana found in over-the-counter cough medicines). and 76.8 percent using alcohol), and just 0.9 percent reported using it in the past month All of these can significantly amplify potential harms. (compared to 19.1 percent using marijuana The most important thing for harm reduction is to know and 59.6 percent using alcohol). 24 what you’re getting. According to Ecstasydata.org – an According to the annual Monitoring the Future independent laboratory testing program of Erowid survey, approximately one percent of college Center – among 250 samples they analyzed in 2014 students and other young adults ages 19-28 that were sold as molly, 40 samples contained MDMA reported using MDMA in the past month with adulterants, and nearly half (124) contained no (compared to 21.6 percent using marijuana MDMA at all!15 and 64.9 percent using alcohol).25 8.